Lee Hyunjung, Singh Gopal K, Jemal Ahmedin, Islami Farhad
Surveillance and Health Equity Science Department, American Cancer Society, Atlanta, Georgia, USA.
Office of Health Equity, Health Resources and Services Administration, US Department of Health and Human Services, Rockville, Maryland, USA.
Cancer. 2024 Jan 1;130(1):86-95. doi: 10.1002/cncr.35042. Epub 2023 Oct 19.
Previous studies have shown an association between living alone and cancer mortality; however, findings by sex and race/ethnicity have generally been inconsistent, and data by socioeconomic status are sparse. The association between living alone and cancer mortality by sex, race/ethnicity, and socioeconomic status in a nationally representative US cohort was examined.
Pooled 1998-2019 data for adults aged 18-64 years at enrollment from the National Health Interview Survey linked to the National Death Index (N = 473,648) with up to 22 years of follow-up were used to calculate hazard ratios (HRs) for the association between living alone and cancer mortality.
Compared to adults living with others, adults living alone were at a higher risk of cancer death in the age-adjusted model (HR, 1.32; 95% CI, 1.25-1.39) and after additional adjustments for multiple sociodemographic characteristics and cancer risk factors (HR, 1.10; 95% CI, 1.04-1.16). Age-adjusted models stratified by sex, poverty level, and educational attainment showed similar associations between living alone and cancer mortality, but the association was stronger among non-Hispanic White adults (HR, 1.33; 95% CI, 1.25-1.42) than non-Hispanic Black adults (HR, 1.18; 95% CI, 1.05-1.32; p value for difference < .05) and did not exist in other racial/ethnic groups. These associations were attenuated but persisted in fully adjusted models among men (HR, 1.13; 95% CI, 1.05-1.23), women (HR, 1.09; 95% CI, 1.01-1.18), non-Hispanic White adults (HR, 1.13; 95% CI, 1.05-1.20), and adults with a college degree (HR, 1.22; 95% CI, 1.07-1.39).
In this nationally representative study in the United States, adults living alone were at a higher risk of cancer death in several sociodemographic groups.
既往研究表明独居与癌症死亡率之间存在关联；然而，按性别和种族/族裔划分的研究结果通常并不一致，且社会经济地位方面的数据较为匮乏。本研究考察了在美国具有全国代表性的队列中，独居与按性别、种族/族裔和社会经济地位划分的癌症死亡率之间的关联。
利用1998 - 2019年全国健康访谈调查中入组时年龄在18 - 64岁的成年人的数据，并与国家死亡指数相链接（N = 473,648），随访时间长达22年，计算独居与癌症死亡率之间关联的风险比（HR）。
与与他人同住的成年人相比，在年龄调整模型中，独居成年人的癌症死亡风险更高（HR，1.32；95%CI，1.25 - 1.39），在对多种社会人口学特征和癌症风险因素进行进一步调整后（HR，1.10；95%CI，1.04 - 1.16）依然如此。按性别、贫困水平和教育程度分层的年龄调整模型显示，独居与癌症死亡率之间存在相似的关联，但在非西班牙裔白人成年人中这种关联更强（HR，1.33；95%CI，1.25 - 1.42），高于非西班牙裔黑人成年人（HR，1.18；95%CI，1.05 - 1.32；差异p值 <.05），在其他种族/族裔群体中不存在这种关联。在对男性（HR，1.13；95%CI，1.05 - 1.23）、女性（HR，1.09；95%CI，1.01 - 1.18）、非西班牙裔白人成年人（HR，1.13；95%CI，1.05 - 1.20）和拥有大学学位的成年人（HR，1.22；95%CI，1.07 - 1.39）的完全调整模型中，这些关联有所减弱但仍然存在。
在这项美国具有全国代表性的研究中，独居成年人在几个社会人口学群体中癌症死亡风险更高。
